Exploration of the Clinical Implementation of Kangaroo Care and Related Factors

• Main Authors: Chan-Chuan Fang, 方嬋娟
• Other Authors: Miao-Ju Chwo
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/05608867270215721910

碩士 === 國防醫學院 === 護理研究所 === 90 === Abstract The purposes of this study were to investigate the clinical implementation of kangaroo care (KC) and related factors. The data collection methods of this study were observation, interview, and questionnaires. Four medical centers and one regional hospital in Taipei were observed from the premature labor at delivery room to the implementation of KC at pediatric ward. The samples consisted of 30 mothers and 35 preterm infants. The head nurses of the KC implementation ward were interviewed. One hundred eighty-one nurses who work in the obstetric or pediatric wards answered the questionnaires. The results indicate that five hospitals only provided the early, intermediate, and late KC at neonatal intensive care unit (NICU), the birth and very early KC were not available at delivery room or recovery room. The opportunities and criteria were preterm infants who have received the close treatment and observation, vital sings stable, no bradycardia or apnea events; preterm infants receiving phototherapy or intubated with assisted ventilation could participate in KC. Not only did mothers provide KC, but also family members, such as father or uncle. Five hospitals only provided privacy with screens for KC practice, no specific KC room was provided. No implemental standard for KC practice and the nurse’s knowledge about KC indication were deficit. The related factors for KC practice in clinical settings were as follows: (1) the preterm infants who have more chance to received KC were the ones with smaller gestational age, lower birth weight, or longer length of stay; (2) mother was confined during the month after childbirth, another child was at home, and parents were lack of information of KC, which prevented mother from visiting her infant; (3) the ward design and nursing theme were the concept of maternal-infant separation which decreased the chance of parent-infant interaction and KC practice; (4) there were lack of implemental standard for KC practice; (5) compared to the nurses in the general ward, nurses had larger workload in the NICU and no time for KC assistance; besides, some nurses’ knowledge about KC were deficit, so they were not actively to supply KC information to parents. From this study, we suggest that nurses need to be educated the knowledge of KC; for example, emphasize the value of KC to early parent-infant interaction, offer evidence-based nursing research of KC benefit to parents, define the policy and procedure standards for KC as routines, and develop the KC brochure for parents. In addition, maternal-infant nursing should be linked together, such as “rooming-in” for preterm infants. Therefore, obstetric nurses can provide the chance for skin-to-skin contact of mother and infant after birth, offer information of KC for parents to overcome the barriers of doing the month or length of stay, and improve the early contact of mother and infant.